Main
Brian Muir, PhD
Highly-inquisitive team-leader with 11+ years of experience employing machine learning and statistics in the healthcare industry and in computational biology. Direct the forecasting of $billions in pharmacy and medical expenses using predictive models in R for Centene Corporation’s (Fortune 500) marketplace insurance LOB.
Professional Experience
Director - Marketplace Forecasting
Centene Corporation / Actuarial Services
Chicago, IL
Current - May 2020
Manager - Analytics & Reporting
Centene Corporation / Actuarial Services
Chicago, IL
May 2020 - Jul 2018
- Direct the development, implementation, and presentation of a highly-visible forecast for 7,000+ financial estimates of medical cost and utilization by month for 27 state health plans and 11 claim categories (e.g. hospital inpatient, primary care, specialty Rx).
- Transformed the medical forecast beyond its essential function as a financial reporting tool by adding member-segmented granularity that pinpoints emerging trends for targeted business actions. Present insights to Centene’s CFO in monthly calls.
- Lead a team of six actuaries and data analysts providing regular guidance and skill training sessions in R.
- Demonstrated ability to build strong collaborations with various technical and non-technical business partners with analytic support and business knowledge across medical, pharmacy, provider, membership, health status, sales, and payment data.
- Proven record of quickly adapting team workflow to incorporate forecast estimates for direct and indirect COVID costs and various health care policy changes that impacted membership makeup and anticipated costs.
- Developed a member-level gross margin database that integrates disparate revenue and expense financial data with 40 targeted member, provider, and broker characteristics. Deployed a drill-down dashboard in RSConnect utilized widely for strategic decision making and business initiatives across departments.
- Identified an $8M annual initiative improving on risk adjustment code capture by data-mining pharmacy prior authorization data.
Data Scientist I
Centene Corporation / Business Optimization
Chicago, IL
Jul 2018 - Oct 2017
Data Analyst II
Centene Corporation / Business Optimization
Chicago, IL
Oct 2017 - Sep 2016
- Built and implemented a novel claims completion model using regression to estimate incurred-but-not-reported expenses prior to month end. Model is used for early-warning and to accelerate preparation of financial reporting and commentary.
- Developed a probability-based outlier detection model for episodes of care that is used to highlight targets for quality and cost-saving initiatives.
- Designed enterprise’s primary care auto-assignment algorithm to optimally assign members to local providers identified as high-quality and low-cost.
- Devised interactive RMarkdown reports using automated commentary to highlight emerging trends in Rx utilization. Present findings monthly to Pharmacy Directors of local health plans.
Research Experience
Graduate Research Assistant / Computational Biology
University of California Riverside
Riverside, CA
Sep 2010 - Aug 2016
- Analyzed large gene expression datasets with R (Bioconductor) using non-parametric statistical models.
- Performed statistical tests of codon evolution in cancer gene-sequence alignments using maximum likelihood models.
- Designed and directed a multi-year longitudinal experimental evolution study on fruit flies that employed advanced experimental design statistics. Supervised two to six undergraduate volunteer research assistants per quarter.
- Taught 18 quarters of upper and lower division biology courses with up to 150 students per week.
- Mentor of five fellow graduate students in Graduate Student Mentorship Program.
Education
University of California Riverside
Ph.D. in Evolution, Ecology & Organismal Biology
Riverside, CA
2016 - 2010
Boston College
B.S. in Biology, Psychology (Double Major)
Chestnut Hill, MA
2010 - 2006
Publications and Presentations
The expression of tumour suppressors and proto-oncogenes in tissues susceptible to their hereditary cancers.
Muir, B. & Nunney, L. British journal of cancer, 113(2), 345-353.
N/A
2015
Peto’s paradox and the hallmarks of cancer: constructing an evolutionary framework for understanding the incidence of cancer.
Nunney, L. & Muir, B. Phil. Trans. R. Soc. B, 370(1673), 20150161.
N/A
2015
Presentations
International Scientific Conferences
N/A
2014-2015
- International Biannual Evolution and Cancer Conference - Lightning Talk & Poster | 2015
- Evolution Conference - Talk | 2014
Exams & Awards
Exams
Society of Actuaries
N/A
2018-
- PA - Predictive Analytics | Jun 2019
- SRM - Statistics for Risk Modeling | Jan 2019
- P - Probability | Sep 2018
Awards
Research and Education
N/A
2010-2016
- GAANN Fellowship | U.S. Department of Education | 2016
- Outstanding Teaching Assistant | UCR Graduate Division | 2015
- Dissertation Year Fellowship Award | UCR | 2015
- Chancellor’s Distinguished Fellowship Award | UCR | 2010